"Ex vivo" surgery works for abdominal tumors

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A novel surgical technique that involves the temporary removal of entire abdominal organs enables surgeons to take out tumors that are unresectable by the usual surgical methods.

In their case report, published in American Journal of Transplantation (2012;12[5]:1323-1328), a team of surgeons led by Tomoaki Kato, MD, of Columbia University, New York, New York, described their removal of tumors in three patients. The tumors involved both the celiac artery and the superior mesenteric artery.

In this new approach, known as multivisceral ex vivo surgery, the entire abdominal viscera were removed, the tumor was cut out, and the blood vessels were reconstructed using synthetic vascular grafts. The organs were then reimplanted into the abdomen, with surgeons reconnecting blood vessels and GI tracts.

All three patients remain alive with no tumor recurrence at 17, 27, and 38 months after surgery. Postoperative complications included diarrhea, sphincter of Oddi dysfunction, and arterial stenosis, all of which responded to directed treatments.

The authors conclude that multivisceral ex vivo surgery may prove to be a useful treatment for tumors thought of as inoperable. They contend that the surgery is most suitable for locally invasive tumors that are unresectable due to location and vascular involvement.

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